BAXDELA SIDE EFFECTS
- Generic Name: delafloxacin injection, tablets
- Brand Name: Baxdela
- Drug Class: Fluoroquinolones
SIDE EFFECTS
The following serious and otherwise important adverse reactions are discussed in greater detail in other sections of labeling:
- Disabling and Potentially Irreversible Serious Adverse Reactions
- Tendinitis and Tendon Rupture
- Peripheral Neuropathy
- Central Nervous System Effects
- Hypersensitivity Reactions
- Clostridium difficile-Associated Diarrhea
- Blood Glucose Disturbances
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in clinical trials of BAXDELA cannot be directly compared to rates in the clinical trials of another drug and may not reflect rates observed in practice.
Overview Of The Safety Evaluation Of BAXDELA
BAXDELA was evaluated in three Phase 3 multicenter, multinational, randomized, double-blind clinical trials. These trials included two trials in ABSSSI patients (Trial 1 and Trial 2) and one trial in CABP (Trial 3). A total of 1170 patients were treated with BAXDELA across all Phase 3 trials (741 patients in the two ABSSSI trials and 429 patients in the CABP trial).
Acute Bacterial Skin And Skin Structure Infections (ABSSSI)
BAXDELA was evaluated in two multicenter, multinational, randomized, double-blind, double-dummy, noninferiority trials (Trial 1 and Trial 2) in adults with ABSSSI. In Trial 1 patients received BAXDELA 300 mg by intravenous infusion every 12 hours and in Trial 2 the patients received BAXDELA 300 mg by intravenous infusion every 12 hours for 6 doses then were switched to BAXDELA 450 mg tablets every 12 hours. The total treatment duration was 5 to 14 days. Adverse reactions were evaluated for 741 patients treated with BAXDELA and 751 patients treated with comparator antibacterial drugs. The median age of patients treated with BAXDELA was 49 years, ranging between 18 and 94 years old; 15% were age 65 years and older. Patients treated with BAXDELA were predominantly male (62%) and Caucasian (86%). The BAXDELA treated population included 44% obese patients (BMI ≥ 30 kg/m²), 11% with diabetes, and 16% with baseline renal impairment (calculated creatinine clearance less than 90 mL/min).
Serious Adverse Reactions And Adverse Reactions Leading To Discontinuation
Serious adverse reactions occurred in 3/741 (0.4%) of patients treated with BAXDELA and in 6/751 (0.8%) of patients treated with the comparator.
BAXDELA was discontinued due to an adverse reaction in 7/741 (0.9%) patients and the comparator was discontinued due to an adverse reaction in 21/751 (2.8%) patients. The most commonly reported adverse reactions leading to study discontinuation in the BAXDELA arm included urticaria (2/741; 0.3%) and hypersensitivity (2/741; 0.3%); whereas, the most commonly reported adverse reactions leading to study discontinuation in the comparator arm included urticaria (5/751; 0.7%), rash (4/751; 0.5%), hypersensitivity and infusion site extravasation (2/751; 0.3%).
Most Common Adverse Reactions
The most common adverse reactions in patients treated with BAXDELA were nausea (8%), diarrhea (8%), headache (3%), transaminase elevations (3%), and vomiting (2%). Table 4 lists selected adverse reactions occurring in ≥ 2% of patients receiving BAXDELA in the pooled adult Phase 3 clinical trials.
Table 1 : Selected Adverse Reactions Occurring in ≥ 2% of Patients Receiving BAXDELA in the Pooled Adult Phase 3 ABSSSI Clinical Trials
| Adverse Reactions | BAXDELA N = 741 (%) |
Vancomycin /aztreonam N = 751 (%) |
| Nausea | 8% | 6% |
| Diarrhea | 8% | 3% |
| Headache# | 3% | 6% |
| Transaminase Elevations* | 3% | 4% |
| Vomiting | 2% | 2% |
| # The data are not an adequate basis for comparison of rates between the study drug and the active control. *Pooled reports include hypertransaminasaemia, increased transaminases, and increased ALT and AST. |
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Community-Acquired Bacterial Pneumonia
BAXDELA was evaluated in one multicenter, multinational, randomized, double-blind trial in adults with CABP (Trial 3). Patients received BAXDELA 300 mg over 60 minutes every 12 hours for a minimum of 6 doses with an option to switch to oral BAXDELA tablet 450 mg every 12 hours for the remaining doses (total of 10 to 20 doses of intravenous infusion and oral combined). Adverse reactions were evaluated for 429 patients treated with BAXDELA and 427 patients treated with moxifloxacin. The median age of patients treated with BAXDELA was 63 years, ranging between 18 and 89 years; 47.1% were 65 years of age and older and 19.6% were 75 years of age and older. Patients treated with BAXDELA were predominantly male (58.3%) and white (92.3%). The BAXDELA-treated population included patients with obesity (BMI greater than or equal to 30) (24.0%), COPD/asthma (14.2%), cardiac disease (24.2%), diabetes (16.3%), and baseline renal impairment including 36.4% with moderate renal impairment (CrCl less than 30-59 mL/min), and 4.0% with severe renal impairment (CrCl less than 29 mL/min). Overall, approximately 12.4% of patients were in PORT Risk Class II, 60.1% were in PORT Risk Class III, 26.6% were in PORT Risk Class IV, and 0.9% were in PORT Risk Class V.
Serious Adverse Reactions And Adverse Reactions Leading To Discontinuation
Serious adverse reactions occurred in 2/429 (0.5%) of patients treated with BAXDELA and in 1/427 (0.2%) of patients treated with moxifloxacin. Discontinuation due to an adverse reaction occurred in 9/429 (2.1%) patients treated with BAXDELA and in 4/427 (0.9%) treated with moxifloxacin. The most commonly reported adverse reactions leading to study drug discontinuation in the BAXDELA arm were transaminase elevations (2/429; 0.5%). The most commonly reported adverse reactions leading to study drug discontinuation in the comparator arm were infusion site reactions (1/427; 0.2%).
Most Common Adverse Reactions
The most common adverse reactions in patients treated with BAXDELA were diarrhea (5%) and transaminase elevations (5%). Table 5 lists selected adverse reactions occurring in ≥ 2% of patients receiving BAXDELA in the adult Phase 3 CABP clinical trial.
Table 2 : Selected Adverse Reactions Occurring in ≥ 2% of Patients Receiving BAXDELA in the Adult Phase 3 CABP Clinical Trial
| Adverse Reactions | BAXDELA N = 429 |
Moxifloxacin N = 427 |
| Diarrhea | 5% | 3% |
| Transaminase elevations* | 5% | 3% |
| * Includes hepatic enzyme increased, transaminases increased and alanine aminotransferase (ALT) increased. | ||
Adverse Reactions Occurring In Less Than 2% Of Patients Receiving BAXDELA In The ABSSSI (Trials 1 And 2) And CABP (Trial 3) Clinical Trials
The following selected adverse reactions were reported in BAXDELA-treated patients at a rate of less than 2% in the ABSSSI (Trials 1 and 2) and CABP (Trial 3) clinical trials:
Blood and Lymphatic System Disorders: agranulocytosis, anemia, leukopenia, neutropenia, pancytopenia
Cardiac Disorders: sinus tachycardia, palpitations, bradycardia, ventricular extrasystoles
Ear and Labyrinth Disorders: tinnitus, vertigo, vestibular disorder
Eye Disorders: vision blurred
General disorders and administration site conditions: infusion related reactions
Gastrointestinal Disorders: abdominal pain, dyspepsia
Immune System Disorders: hypersensitivity
Infections and Infestations: Clostridium difficile infection, fungal infection, oral candidiasis, vulvovaginal candidiasis
Laboratory Investigations: blood alkaline phosphatase increased, blood creatinine increased, blood creatine phosphokinase increased
Metabolism and Nutrition Disorders: hyperglycemia, hypoglycemia
Musculoskeletal and Connective Tissue Disorders: myalgia
Nervous System Disorders: dizziness, hypoesthesia, paraesthesia, dysgeusia, presyncope, syncope
Psychiatric Disorders: agitation, anxiety, confusional state, insomnia, abnormal dreams
Renal and Urinary: renal impairment, renal failure
Skin and Subcutaneous Tissue Disorders: pruritus, urticaria, dermatitis, rash
Vascular Disorders: flushing, hypotension, hypertension.
SRC: NLM .